OCCLUSION IN ORTHODONTICS - Harvard...
Transcript of OCCLUSION IN ORTHODONTICS - Harvard...
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OCCLUSION IN ORTHODONTICS
Veerasathpurush Allareddy, BDS MBA MHA MMSc PhD
Department of Developmental Biology
Boston Children’s Hospital
Harvard School of Dental Medicine
04/23/2013
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OUTLINE
• History
• Terminology
• Occlusion – definition
• Angle’s Classification
• Andrew’s Six Keys to Occlusion
• Clinical Scenarios
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History
• Dr. Edward H. Angle
• First dental specialty: Orthodontics
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Terminology
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Orientations
Buccal
Lingual
Mesial Distal
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Overjet
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Overbite
OB
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Curve of Wilson
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Transverse Occlusal Deviations
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Midline Deviation
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Midline Deviation
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Midline Deviation
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Functional Shift
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Curve of Spee
Curve of spee is 3.5 mm
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OCCLUSION
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DEFINITION
“The relationship of the mandibular and maxillary teeth as they are brought into functional contact”
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COMPLEXITY OF OCCLUSION
• Teeth (morphology and angulation)
• Masticatory muscles
• Skeletal structures
• Temporomandibular joints
• Functional jaw movements
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ANGLE’S CLASSIFICATION
Mesiobuccal cusp of maxillary first molar rests on the buccal groove of the mandibular first molar
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CLASS II
Class II Division I Class II Division II
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CANINE CLASSIFICATION
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CANINE CLASSIFICATION
A. Class I - Maxillary canine fits in the embrasure between the mandibular canine and first premolar
B. Class II - Maxillary canine occludes mesial to Class I
C. Class III - Maxillary canine occludes distal to Class I
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ANDREW’S SIX KEYS OF NORMAL
OCCLUSION
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SIX KEYS OF NORMAL OCCLUSION
• Molar interarch relationship
• Mesiodistal crown angulation
• Labiolingual crown inclination
• Rotations
• Tight contacts
• Occlusal plane (curve of spee)
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MOLAR INTERARCH RELATIONSHIP • Mesiobuccal cusp of maxillary first molar occludes in
the buccal groove of mandibular first molar
• Mesiolingual cusps of the maxillary first molar occludes in the central fossa of the mandibular first molar
• Distal marginal ridge of the maxillary first molar occludes with the mesial marginal ridge of the mandibular second molar
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MOLAR INTERARCH RELATIONSHIP
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MOLAR INTERARCH RELATIONSHIP
YES
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MESIODISTAL CROWN ANGULATION
Gingival part of the long axis of the crown must be distal to the occlusal part of the axis
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LABIOLINGUAL CROWN INCLINATION BETWEEN MAXILLARY AND MANDIBULAR INCISORS
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LABIOLINGUAL CROWN INCLINATION OF POSTERIOR TEETH
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NO ROTATIONS
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TIGHT CONTACTS – NO SPACING
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CURVE OF SPEE
A. Excessive
B. Normal
C. Reverse
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REFERENCES Casko J et al. "Objective grading system for dental casts and panoramic radiograph," The American Journal of Orthodontics and
Dentofacial Orthopedics, 114:590-599, 1998.
Cangialosi TJ. “The ABO discrepancy index: A measure of case complexity.” American Journal of Orthodontics and Dentofacial Orthopedics, 125(3):270-278, Mar 2004.
Riolo et al. "ABO Resident Clinical Outcomes Study: Case Complexity as Measured by the Discrepancy Index.” American Journal of Orthodontics and Dentofacial Orthopedics, pp. 161-163, Feb 2005.
Andrews LF. "The Six Keys to Normal Occlusion." American Journal of Orthodontics, 62:296-309, 1972.
Proffit WR et al. “Contemporary Orthdontics”. Fourth edition. Mosby.
English JD et al. “Mosby’s Orthodontic Review”. Mosby.
Rakosi T et al. “Color Atlas of Dental Medicine - Orthodontic Diagnosis”. Thieme.
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CLINICAL SCENARIOS
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